Trends in keratoplasty from central and Northern India. Part I: Indications for keratoplasty

Author:

Parmar Gautam1,Chatterjee Samrat2,Kapur Neha3,Gomase Sharad N2,Khurana Ashi4,Borde Prashant1,Acharya Manisha3,Sangwan Virendra S3,Majumdar Atanu5

Affiliation:

1. Department of Cornea and Refractive Surgery, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India

2. Department of Cornea and Anterior Segment, MGM Eye Institute, Raipur, Chhattisgarh, India

3. Department of Cornea and Anterior Segment, Dr. Shroff’s Charity Eye Hospital, New Delhi, India

4. Department of Cornea and Anterior Segment, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India

5. Department of Biostatistics, Dr. Shroff’s Charity Eye Hospital, New Delhi, India

Abstract

Purpose: To report the indications for keratoplasty and analyze trends in two decades in India. Methods: This was a retrospective review of eye bank registries of six tertiary eye care centers located in central and northern India from 2005 to 2021. The patterns of corneal pathology and changes in trends were analyzed. Results: Between 2005 and 2021, 13223 corneal grafts were performed in the six collaborating tertiary eye care centers. The most common indication for keratoplasty in both decades was corneal ulcer (41.1%), followed by corneal scar (25.5%), failed graft (12.0%), post-cataract surgery corneal edema (11.7%), corneal dystrophies (3.1%), corneal ectasia (1.8%), corneal trauma (0.3%), congenital corneal opacity (0.3%), and others (4.1%). An increasing trend was seen in corneal ulcers, failed grafts, and keratoconus. A reducing trend was seen in corneal scar and aphakic bullous keratopathy. There was no change in pseudophakic bullous keratopathy and Fuchs endothelial corneal dystrophy. Conclusion: Corneal ulcers, corneal scars, failed grafts, and post-cataract surgery corneal edema remained the foremost indications for keratoplasty in two decades in India. An increasing trend was seen in corneal ulcers and failed grafts which are of concern as these indications carry a poorer outcome. Capacity building in lamellar keratoplasty techniques is the need of the hour as pseudophakic bullous keratopathy was an important indication, and an increasing trend was noticed in keratoconus.

Publisher

Medknow

Subject

Ophthalmology

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